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+ Learning Objectives Describe what clinical psychology is and how clinical psychologists are trained Discuss some of the career paths available to clinical psychologists Explain key challenges for the field of clinical psychology

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+ What is Clinical Psychology? The integration of science, theory and practice to understand, predict and alleviate maladjustment, disability and discomfort as well as to promote human adaptation, adjustment and personal development. -American Psychological Association, Society of Clinical Psychology (Division 12)

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+ Ph.D versus Psy.D. : Whats the difference? Ph.D programs Follow a scientist-practitioner model of training Heavy emphasis on research and preparation for a career in clinical and academic settings Smaller class sizes (4-15 students) and funding for students masters thesis and dissertation research with data collection Psy.D programs Follow a practitioner-scholar model of training Heavier emphasis on clinical work and research related to clinical practice Larger class sizes (100+), high tuition costs, no financial support, lower internship match rates that result in students completing internships at non-accredited sites Rarely involves masters thesis and dissertation can be a theory paper in many programs

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+ Counseling Psychology PhD Leads to same license as clinical psychology PhD Smaller number of programs, with slightly different emphasis (similar to D.O. vs. M.D. training) VCU Psychology Department has both programs (very unusual) with large overlap in courses and training. Both work on MCV campus and in primary care.

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+ The Training of Clinical Psychologists Undergraduate education Graduate education 5-6 years to earn Ph.D. Internship required to earn Ph.D (shortage of accredited internships has created stress for students and training programs) Post-doctoral fellowship (Optional in some cases) Licensure and board certification Continuing education to maintain license and certifications Training Overview

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+ Two Tracks in Clinical Program at VCU Generalist training focused on psychopathology, assessment, treatment and research with adults Specialist training for research and clinical work in health settings * Also know as Health Psychology. VCU Counseling PhD has same track. Training focused on understanding human development, family and social aspects of human development, research, assessment and the treatment of children and adolescents with psychopathology. Behavioral Medicine* Child and Adolescent

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+ Year One Complete coursework Intellectual & personality assessment, psychopathology, biological basis of behavior, statistics, behavior therapy and clinical interviewing skills Work ~ 20 hours at an assistantship Teaching a course or the lab/discussion section of an undergraduate or graduate course Recruiting participants for a faculty members research, running intervention groups or collecting data from participants or analyzing data Independent research Collaborating with a faculty advisor or mentor Reading and discussing literature for thesis Analyzing data for an abstract or poster for a conference

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+ Year Two Complete coursework Research methodology, psychometrics, health psychology, learning and cognition and neuropsychology Work ~ 20 hours at an assistantship Begin clinical practicum at CPSD Independent Research Thesis proposal and data collection

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+ Clinical practicum at the Center for Psychological Services and Development (CPSD) 2 nd year students begin working as staff therapists at the CPSD in the fall semester CPSD is a clinic operated by VCUs Psychology department Services are provided on a sliding fee scale based on patients income and insurance Services include Individual therapy for children and adults Couples therapy Assessment (court ordered evaluations, ADHD/LD, therapeutic & neuropsychological) Family therapy Group therapy Career counseling

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+ Year Four Begin off-campus practicum Continue with clinical work at Anxiety clinic or Primary Care Clinics Independent research Internship applications and interviews Work ~ 20 hours at assistantship

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+ Off-campus Practicum Training 3rd year students apply to work at several training sites within the Metro Richmond area or DC area Training sites Hunter Holmes McGuire VAMC Virginia Treatment Center for Children Central State Psychiatric Hospital, Petersburg, VA UVA Center for Addiction Research and Education VCU Department of Psychiatry: burn unit, transplant and gastric bypass evaluations and treatment

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+ Internship Application process includes a written application, an invitation to interview, interviews and then match process similar to medical residency Internships typically begin in July or August and include extensive training for one year Internship allows students the opportunity to work autonomously in a new setting and to experience some of the challenges that licensed clinicians face Interns continue to receive supervision and training through clinical rotations, where they often have the opportunity to practice in sub-specialties such as neuropsychology, forensic psychology, integrated primary care psychology, rehabilitation psychology, sports psychology, program evaluation and development.

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+ Post-graduate training Post-doctoral fellowship 2 year training opportunity Training in a sub-specialty area such as neuropsychology, addiction psychology, primary care psychology and health disparities research Mixture of research and clinical focus with some programs emphasizing one area over the other Provides clinical hours needed to achieve board credentials in sub-specialty areas Licensure and credentialing Licensure by state board Credentialing by specialty boards and professional organizations American Board of Professional Psychology Continuing education requirements

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+ What do clinical psychologists do? Assess intellectual development, psychopathology, adjustment and personal growth Treat psychological disorders and individuals experiencing symptoms of psychological distress in a variety of settings Teach at university psychology and psychiatry departments Conduct research in the community Consult with government agencies, private institutions, businesses and organizations Lead and participate in professional organizations Publish and edit journals and books

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+ Career paths of VCU grads 65% work at academic medical centers or VA hospitals with adult or pediatric populations and are frequently involved in both clinical service and research 20% work in private practice 5-10% work at universities or colleges as tenure track professors 5-10% work as administrators for various health care organizations

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+ Five challenges for the profession of clinical psychology: Are for-profit programs creating too many psychologists and how will this affect the field over time? Note: most limitations placed on the free market of training would be considered illegal Shortage of accredited internships, required by many programs and licensure boards Differentiating competencies and justifying higher reimbursement rates for doctoral trained psychologists relative to masters level mental health providers Moving toward an outcomes oriented reimbursement model that still embraces diverse orientations to practice Clinical psychologists continuing to find new niches that capitalize on unique expertise in measurement and research skills

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+ Summary Complete rigorous training to achieve a Ph.D. or Psy.D., licensure and credentials Use their knowledge of science and research to understand and treat a variety of disorders or promote adjustment Practice in a variety of settings Fulfill many roles as researchers, educators, consultants and clinicians Clinical psychologists: